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Related Concept Videos

Pulmonary Tuberculosis IV01:26

Pulmonary Tuberculosis IV

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Tuberculosis, more commonly referred to as TB, is an infectious disease stemming from Mycobacterium tuberculosis. While it primarily impacts the lungs, TB can also affect other body areas. Given its severity and global impact, timely and accurate diagnosis is crucial for controlling its spread and improving patient outcomes.
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...
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Development and Validation of an Ultrasensitive Single Molecule Array Digital Enzyme-linked Immunosorbent Assay for Human Interferon-α
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Performance of LTBI Screening in Patients with Rheumatic Diseases Using Two Different Interferon-Gamma Releasing

Le Zhang1,2, Jiawei Zhang1, Shaoying Yang1

  • 1Department of Rheumatology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, 200002 Shanghai, China.

Frontiers in Bioscience (Landmark Edition)
|November 7, 2022
PubMed
Summary

The T-SPOT.TB test provides more definitive latent tuberculosis infection (LTBI) screening results than QuantiFERON-TB Gold in-tube (QFT-GIT) for rheumatic disease patients, especially those with systemic lupus erythematosus (SLE). Lower lymphocyte counts predict indeterminate QFT-GIT results in SLE patients.

Keywords:
QuantiFERON-TB Gold in-tube test (QFT-GIT)T-SPOT.TB test (T-SPOT)latent tuberculosis infection (LTBI)rheumatic diseases (RDs)

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Area of Science:

  • Immunology
  • Rheumatology
  • Infectious Disease

Background:

  • Latent tuberculosis infection (LTBI) screening is crucial for patients with rheumatic diseases (RDs) initiating immunosuppressive therapy.
  • Interferon-gamma release assays (IGRAs) like QuantiFERON-TB Gold in-tube (QFT-GIT) and T-SPOT.TB (T-SPOT) are commonly used for LTBI screening.
  • Evaluating IGRA concordance in RDs is essential for accurate diagnosis and treatment decisions.

Purpose of the Study:

  • To compare the concordance between QFT-GIT and T-SPOT for LTBI screening in patients with RDs.
  • To identify factors associated with indeterminate IGRA results in this population.

Main Methods:

  • Prospective recruitment of 108 RD patients (64 SLE, 44 inflammatory arthritis) undergoing IGRA testing from 2019-2020.
  • Assessment of QFT-GIT and T-SPOT concordance using Kappa analysis.
  • Multivariable logistic regression to explore predictors of indeterminate results.

Main Results:

  • Poor concordance between QFT-GIT and T-SPOT was observed in SLE patients (K=0.175), contrasting with moderate concordance in inflammatory arthritis (K=0.539).
  • Indeterminate results were significantly more frequent with QFT-GIT than T-SPOT in SLE patients (18.8% vs. 4.7%, p=0.013).
  • Lower lymphocyte counts independently predicted indeterminate QFT-GIT results in SLE patients (OR=0.81, p=0.020).

Conclusions:

  • T-SPOT.TB testing offers more definitive LTBI screening results compared to QFT-GIT in patients with rheumatic diseases.
  • The concordance between these IGRAs is particularly poor in patients with systemic lupus erythematosus.
  • Understanding factors leading to indeterminate results, such as low lymphocyte counts in SLE, is critical for optimizing LTBI screening strategies.